Liquid lipoprotein control

ABSTRACT

An accurate, stable, liquid lipoprotein control composition is provided. The control composition of the present invention preferably comprises lipoprotein, suffactant and a divalent cation. The control may further comprise a chelating agent. It has been surprisingly found that when suffactant and a divalent cation are added to lipoprotein, it performs like native lipoprotein in human serum, i.e. not aggregated or subject to matrix effects. In addition, the control composition of the present invention is stable for up to about 5 months at room temperature (about 22° C.) and up to about 12 months when refrigerated (about 2° C. to about 10° C.). Methods of making and using the control composition are also provided.

FIELD OF THE INVENTION

The present invention relates generally to lipoprotein controls and more particularly, to a stable, liquid, lipoprotein control composition, and methods of making and using the same.

BACKGROUND OF THE INVENTION

Lipoproteins are water soluble conjugated proteins. They are conjugated with lipids-substances such as cholesterol, triglycerides and phospholipids. Cholesterol, triglycerides and phospholipids are all insoluble in aqueous solutions. They are conjugated to proteins which make them soluble in serum.

The association of cholesterol and lipoproteins with arteriosclerosis has led to the frequent evaluation of cholesterol and lipoprotein in human serum. It is known that elevated total cholesterol and elevated low density lipoprotein (LDL) cholesterol levels may lead to poor cardiovascular health while elevated high density lipoprotein (HDL) cholesterol does not have a negative influence on cardiovascular health and may even improve the condition of cardiovascular health. Because of the association of cholesterol and lipoproteins with cardiovascular health and because it has been demonstrated that LDL cholesterol can be decreased and HDL cholesterol increased by diet, exercise and drugs, several clinical assays have been developed to measure lipoprotein, triglycerides and cholesterol.

A typical assay for lipid analysis often includes values for cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, phospholipids, cholesterol esters, free fatty acids, apolipoprotein A1 and apolipoprotein B. In routine practice, LDL cholesterol is estimated using the Friedwald equation wherein LDL cholesterol is calculated by subtracting measured HDL cholesterol and estimated very low density lipoprotein (VLDL) cholesterol (approximated as one-fifth of the serum triglyceride) from total cholesterol. HDL cholesterol may be measured by various methods such as density separation using ultracentrifugation, electrophoresis or enzyme-linked methods employing cholesterol oxidase and photometric measurement. When the later method is employed, the VLDL. and LDL cholesterol is first precipitated from the serum with reagents such as heparin, dextran sulfate and magnesium ion or phosphotungstate. The HDL cholesterol remaining in the supernatant can then be measured.

Controls are used to objectively evaluate the accuracy and precision of lipoprotein testing procedures. Unfortunately, the freezing and lyophilization of lipoprotein controls leads to aggregation and turbidity of lipoprotein solutions. Another disadvantage in lipoprotein controls is reconstitution of lyophilized controls which can lead to inaccuracies due to volumetric measurements. Various approaches to improving lipid controls (triglycerides and total cholesterol) have thus been developed.

For example, in U.S. Pat. Nos. 4,816,411 and 4,503,146 (incorporated by reference), turbidity in biological fluid such as plasma or serum is reduced by adding a surfactant and cholesterol esterase or lipase, to degrade the lipoproteins. These patents describe photometric assays for cholesterol and triglycerides, wherein clear samples are essential. U.S. Pat. Nos. 4,626,511 and 5,310,679 (incorporated by reference), also disclose reduction of turbidity by the addition of a surfactant and lipolytic enzyme to degrade the lipoproteins.

In U.S. Pat. No. 4,011,045 (incorporated by reference), lipoproteins are precipitated from serum by the addition of divalent cations and dextran sulfate. The large lipoproteins are discarded and the short chain triglycerides are added back to the serum. The added triglycerides in serum are then emulsified by using the surfactant alkylphenoxypolyethoxyethanol. The serum is then lyophilized and reconstituted to produce a clear preparation.

Similarly, in U.S. Pat. No. 3,955,925 (incorporated by reference), a clear, lyophilized control product is prepared by precipitating lipoproteins from serum with dextran sulfate and divalent cations and adding back to the serum bovine high density lipoprotein which has been purified. Surfactant is also used to remove turbidity in U.S. Pat. Nos. 5,258,315, 4,579,825 and 4,708,939 (incorporated by reference), although no control product is disclosed. Similarly in U.S. Pat. No. 4,289,649 (incorporated by reference), non-ionic and ionic detergent is used to remove turbidity in a control for triglycerides and total cholesterol.

In U.S. Pat. No. 4,127,502 (incorporated by reference), the addition of arabinose, sorbitol, sucrose or glucosamine was shown to reduce the turbidity of lyophilized serum and U.S. Pat. Nos. 4,298,441, 4,045,176 and 4,216,117 (incorporated by reference), disclose that lyophilized control serum which contains non-reducing sugars is stable.

The following U.S. Patents and journal article, which are incorporated by reference herein, relate generally to lipid preparations: U.S. Pat. No. 3,751,381, 3,853,465, 4,189,400, 4,290,774, 3,260,648, 4,414,326 and Hirst, C. F. et al., J. Clin. Pathol. 45:701-703 (1992).

None of the above patents describe stable lipoprotein controls; they are all used for cholesterol and triglyceride standards only. Several recent journal articles make it clear that there is no lipoprotein control which adequately behaves like human serum. In particular, Naito et al., Arch. Pathol. Lab. Med. 117:345-351 (1993), describes the "matrix effects" of known lipoprotein controls used in proficiency studies. Matrix is defined by the National Committee for Clinical Laboratory Standards, Document EP10-T, Vol. 9, No. 3, November, 1988, as "all properties other than the property to be measured, that can have an effect on a measured value," and matrix effects is defined as "an analytic bias due to the matrix of the processed specimen being measured, that is exclusive of calibration." Naito points out that the matrix problems associated with lipoprotein controls severely hamper interlaboratory accuracy, standardization efforts, and monitoring of laboratory performance. It is thus suggested that efforts be made to improve lipoprotein controls so they behave more like human serum.

Likewise, in Kroll, M. H. et al., Clin. Chem. 40:389-394 (1994), it was shown that there is a lack of linearity in high density lipoprotein measurements. Available commercial controls were not linear and it was suggested that the non-linearity is due to alteration of the lipoproteins during lyophilization. Rej. R., Clin. Chem. 40:345-346 (1994) also addresses the inadequacy of available lipoprotein controls and stresses the importance of developing adequate preparations for standardization of methods. The level of importance of this issue is further indicated by an Omnibus Solicitation of the National Institutes of Health, PHS 95-1 (Dec. 1, 1994 Application Receipt Date). The title of the solicitation is "Development of proficiency testing materials free of the matrix effects that compromise accurate measurement of total cholesterol, HDL cholesterol, and LDL cholesterol."

It would thus be desirable to provide an accurate, stable, lipoprotein control. It would further be desirable to provide an accurate, stable, liquid, lipoprotein control that is not lyophilized and reconstituted or frozen and thawed. It would also be desirable to provide an accurate, complete, chemistry control which includes all lipoproteins.

SUMMARY OF THE INVENTION

An accurate, stable, liquid lipoprotein control composition is provided. The control composition of the present invention preferably comprises lipoprotein, surfactant and a divalent cation. It has been surprisingly found that when surfactant and a divalent cation are added to lipoprotein, it behaves like native lipoprotein in human serum, i.e. not aggregated and not subject to matrix effects. The control of the present invention may thus provide all of the lipid parameters: HDL cholesterol, LDL cholesterol, phospholipids, cholesterol esters, free fatty acids, apolipoprotein A1 and apolipoprotein B. Surprisingly, the control composition of the present invention is stable for up to about 5 months at room temperature (about 22° C.) and up to about 12 months refrigerated (about 2° C. to about 10° C.). Methods of making and using the control composition are also provided.

Additional objects, advantages, and features of the present invention will become apparent from the following description and appended claims, taken in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The various advantages of the present invention will become apparent to one skilled in the art by reading the following specification and subjoined claims and by referencing the following drawings in which:

FIG. 1 is a graph illustrating triglyceride stability;

FIG. 2 is a graph illustrating LDL cholesterol stability;

FIG. 3 is a graph illustrating HDL cholesterol stability;

FIG. 4 is a graph illustrating HDL cholesterol stability at various concentration levels;

FIG. 5 is a graph illustrating LDL cholesterol stability at various concentration levels; and

FIG. 6 is a graph illustrating triglyceride stability at various concentration levels.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

An accurate, stable, liquid, lipoprotein control composition is provided. The control composition of the present invention preferably comprises lipoprotein, surfactant and a divalent cation. The control may further comprise a chelating agent. In a preferred embodiment, the control composition comprises by weight from about 0.1% to about 1.5% lipoprotein, from about 0.01% to about 0.5% surfactant and from about 0.05% to about 1.0% divalent cation. Methods of making and using the controls described herein are also provided.

The lipoprotein control composition of the present invention performs like native lipoprotein in serum and, unlike native lipoprotein in serum, is stable. The lipoprotein control is not lyophilized or frozen and therefore does not require thawing or reconstitution. The control composition of the present invention is stable for up to about 5 months at room temperature (about 22° C.) and up to about 12 months refrigerated (about 2° C. to about 10° C.).

Although the control composition of the present invention is described with respect to use as a lipoprotein control, it will be appreciated that the control composition may be used in other applications such as in a complete chemistry control which contains other constituents. For example, analytes such as bilirubin, glucose, potassium, urea, creatinine, sodium, uric acid, ALT (alanine aminotransferase), GGT (y-glutamyltransferase) may be included in the control composition.

A broad range of surfactants may be employed in the control of the present invention including anionic, ionic, non-ionic and zwitterionic surfactants. The following surfactants are most preferred: Triton X705 (Sigma), Silwet 7614 (Union Carbide), Diazopon SS 837 (GAF Chemicals Corp.), pluroinic F-68 (BASF), Polyethylene Glycol 20,000 (Union Carbide) and dioctyl sodium sulfosuccinate. Triton X705 is highly preferred. In addition, although it is believed that any cation may be employed in the control of the present invention, divalent cations are preferred and manganese (Mn⁺⁺), calcium (Ca⁺⁺) and magnesium (Mg⁺⁺) divalent cations are most preferred. Mg⁺⁺ is highly preferred.

As noted above, chelating agents may also be added to the control of the present invention. Preferred chelating agents include ethylenediaminetetracetic acid (EDTA), ethyleneglycol-bis-(β-aminoethyl ether) N,N,N¹,N¹ -tetraacetic acid (EGTA) and sodium citrate. EDTA is most preferred in an amount of up to about 12 mmol.

It has been found that the amount of surfactant employed in the composition of the present invention is directly related to the amount of divalent cation employed. Surprisingly, the amount of divalent cation employed is inversely related to the amount of lipoprotein employed. It would be expected that more divalent cation would be required at a higher lipoprotein concentrations. Hence, when the concentration of lipoprotein is increased, the concentration of divalent cation is decreased and when the concentration of surfactant is increased, the amount of divalent cation is likewise increased. For example, when Triton X705 is increased from about 0.175% to about 0.350%, the optimum Mg⁺⁺ concentration increases from about 6 mM to about 25 mM.

Without wishing to be bound by theory, it is believed that the surfactant of the composition of the present invention acts as a stabilizer of the lipoprotein in solution and the divalent cation eliminates the matrix problems of currently available controls by properly suspending the lipoprotein in solution. That is, the surfactant stabilizes the lipoproteins and prevents the development of aggregation, and the divalent cation allows the lipoproteins to act like native lipoprotein in human serum, Le. the difference between the way the lipoprotein in the control and the lipoprotein in serum react to various manipulations such as precipitation, is the same. It is also believed that the chelating agent stabilizes the divalent cation and inhibits any oxidation of lipoprotein caused by cations such as Fe⁺⁺ which may be present in traces.

Because the lipoprotein of the control substance composition behaves substantially similar to native lipoprotein in serum, the control composition of the present invention may be used with any known method of lipoprotein measurement. For example, total cholesterol and triglyceride control concentrations may be measured by known techniques. The VLDL and LDL cholesterol may then be precipitated from the control with reagents such as heparin, dextran sulfate and magnesium ion and the HDL cholesterol may then be measured by photometric techniques. The LDL cholesterol may then be calculated by subtracting the measured HDL cholesterol concentration and the estimated VLDL cholesterol (approximated as one-fifth of the triglyceride concentration) from total cholesterol. The measured and calculated values of the various lipoprotein components may then be compared to the known values of the control composition, in order to objectively evaluate the accuracy and precision of the lipoprotein testing procedure.

It will be appreciated that as used herein the term "stable" generally refers to maintaining consistency and more particularly, maintaining consistent values for various parameters over a determined period of time. The term "accurate" as referred to herein means providing consistent results substantially similar to known values.

It will also be appreciated by those skilled in the art that the composition of the present invention may include other additives such as antimicrobial agents. It will further be understood that with the teachings of the present application, the skilled artisan will, and without undue experimentation, be enabled to alter concentrations of various components of the composition of the present invention to achieve a desired result.

The following Specific Examples will further describe the present invention.

SPECIFIC EXAMPLE 1

A. Prior Art

Concentrates were prepared from human plasma using dextran sulfate and Mg⁺⁺ as precipitating agents. The methods for preparing high density and low density lipoproteins have been described in Burstein, M., Advan. Lipid. Res. 11:67-108 (1973). The HDL concentrate had an HDL cholesterol of 550 mg/dl. The LDL concentrate had an LDL cholesterol of 950 mg/dl. For these studies, the lipoprotein concentrates were added to a HEPES buffered 0.5% NaCl, pH 7.4, containing 2% bovine serum albumin (BSA). The LDL and HDL concentrates were added to the buffered saline to give the various concentrations of LDL and HDL desired.

To measure cholesterol, an Abbott CCX or a Boehringer Mannhelm Reflotron was employed. The LDL and VLDL cholesterol was precipitated and the HDL cholesterol was measured in the supernatant. Several methods of precipitation are known and the most common methods employ either phosphotungstic acid or dextran sulfate with Mg⁺⁺. Four different phosphotungstic acid reagents were obtained from Sigma, Baxter, Beckman, and DuPont. Each reagent is slightly different in composition. In addition, three different dextran sulfate reagents were obtained from Sigma, Abbott, and DMA.

When the various precipitating agents were compared using the lipoprotein preparation of HDL and LDL, very large differences in HDL cholesterol were obtained. The standard deviation for the six reagents was 15.8. The C. V. was 18. Values as low as 72 mg/dl and as high as 111 mg/dl were found. This is an illustration of the "matrix effect" observed with traditional lipoprotein preparations.

B. Control Composition

A hypothesis was made that lipids tend to coalesce or aggregate in aqueous solutions. To keep them suspended, surfactants or wetting agents were added. The following surfactants were tested: Triton X705 (Sigma), Silwet 7614 (Union Carbide), Diazopon SS837 (GAF Chemicals Corp.), Pluronic F-68 (BASF), Polyethylene Glycol 20,000 (Union Carbide), and dioctyl sodium sulfosuccinate (Sigma). These surfactants were found to provide lipoprotein stability, Le. the cholesterol levels were stable and the HDL and LDL cholesterol values were stable. The values are shown in FIGS. 1-3. The values set forth in FIGS. 1-3 were obtained using 150 mg/dl of dioctyl sodium sulfosuccinate. No significant change occurred over 200 days at 22° C. It is thus clear that a broad range of surfactants will stabilize the lipoprotein values for extended periods of time at room temperature.

The effect of varying the concentration of surfactant was examined by testing different concentrations of surfactant using the same concentration of lipoprotein. The results of this experiment is shown in Table 1 below. As shown in Table 1, as the concentration of Triton X705 is increased, the HDL cholesterol is increased. The higher concentrations of surfactant are thus inhibiting the precipitation of the LDL and VLDL and therefore the surfactants are stabilizing the lipoproteins. However, with surfactant alone, the lipoproteins do not behave in a manner similar to human serum and a severe matrix problem is produced as evidenced by the values in Table 1.

                  TABLE 1                                                          ______________________________________                                         Effect of Concentration of Surfactant                                          Precipitating                                                                             Measured HDL Cholesterol mg/dl                                      Reagent    0.05% X705  0.25% X705                                                                               0.50% X705                                    ______________________________________                                         Sigma (PTA)                                                                               34.3        76.0      193                                           Baxter (PTA)                                                                              41.1        103       224                                           Beckman (PTA)                                                                             25.3        43.7      63.8                                          DuPont (PTA)                                                                              42.2        103       216                                           Sigma (DEX)                                                                               37.9        47.0      47.9                                          Abbott (DEX)                                                                              32.1        46.1      45.3                                          DMA (DEX)  35.8        47.1      44.5                                          Mean:      35.5        66.4      119                                           S.D.:      5.76        27.1      86.5                                          C.V.:      16.2%       40.8%     72.6%                                         ______________________________________                                    

It was discovered that the addition of a divalent cation such as Mg⁺⁺, Ca⁺⁺, of Mn⁺⁺ will eliminate the matrix problems. In addition, it was discovered that the use of a chelating agent and in particular EDTA, stabilizes the divalent cation and also inhibits oxidation of the lipoprotein. (It is known that Fe⁺⁺⁺ ions in traces will cause oxidation of lipoproteins). The results of a study investigating the effect of divalent cation and EDTA are set forth in Table 2 below. In Table 2, Sample 1 is the control and thus contained no surfactant, no MgCl₂, and no EDTA. Sample 2 contained 0.175 g/dl Triton X705, no MgCl₂ and no EDTA. Sample 3 contained no Triton X705, 8 mM MgCl₂ and 3 mM EDTA. Sample 4 contained 0.175 g/dl Triton X705, 8 mM MgCl₂ and 3 mM EDTA.

                  TABLE 2                                                          ______________________________________                                         Effect of Surfactant (Triton X705) and a Divalent Cation (MgCl.sub.2)          on the Precipitation of LDL                                                    Values HDL Cholesterol mg/dl                                                   Precipitating                                                                  Agent     Sample 1 Sample 2   Sample 3                                                                              Sample 4                                  ______________________________________                                         Sigma (PTA)                                                                              37.3     43.5       18.0   44.8                                      DuPont (PTA)                                                                             42.8     94.4       25.1   48.0                                      Abbott (Dex)                                                                             34.5     45.7       37.3   47.4                                      Sigma (Dex)                                                                              42.1     49.3       39.7   48.5                                      Mean:     39.2     58.2       30.0   47.2                                      C.V.:     10.2%    41.6%      34.3%  3.53%                                     ______________________________________                                    

The effect of varying the concentration of divalent cation was also investigated. Various concentrations of MgCl₂ were tested and the results are set forth in Tables 3 and 4 below. These data indicate that at 0.175 mg/dl of Triton X705, the optimum Mg⁺⁺ is approximately 6 mM. (Table 3: CV=5.6%) These data also indicate that as the concentration of lipoprotein is increased, the level of Mg⁺⁺ required decreased. This can be seen in Tables 3, 4A and 4B. As shown in Table 3, at the highest level of lipoprotein, the optimum Mg⁺⁺ concentration is 6 mM (HDLC cholesterol=80 mg/dl). As shown in Table 4A, at the intermediate level of lipoprotein, wherein the HDL cholesterol concentration is 48 mg/dl, the optimum concentration is 8 mM Mg⁺⁺. As shown in Table 4B, at the lowest level of HDL cholesterol wherein the lipoprotein concentration is 24 mg/dl, the optimum concentration is 20 mM Mg⁺⁺.

                  TABLE 3                                                          ______________________________________                                         Effect of Divalent Cation Concentration                                        Values HDL Cholesterol mg/dl                                                   Precipitating        MgCl at  MgCl at                                                                               MgCl at                                   Reagent    No Mg++   6 mM     20 mM  30 mM                                     ______________________________________                                         Sigma (PTA)                                                                               94.3      74.6     40.4   49.7                                      Baxter (PTA)                                                                              106       80.6     47.1   40.4                                      Beckman (PTA)                                                                             72.9      74.5     68.7   17.1                                      DuPont (PTA)                                                                              111       82.9     53.6   44.2                                      Sigma (DEX)                                                                               75.1      82.0     80.5   79.0                                      Abbott (DEX)                                                                              76.3      82.0     84.2   83.3                                      DMA (DEX)  78.4      86.9     81.5   82.5                                      Mean:      87.6      80.5     65.1   56.6                                      S.D.:      15.8      4.50     18.0   25.5                                      C.V.:      18.0%     5.60%    27.7%  45.2%                                     ______________________________________                                    

                  TABLE 4A                                                         ______________________________________                                         Intermediate Lipoprotein Level                                                 Values HDL Cholesterol mg/dl                                                   Precipitating        MgCl at  MgCl at                                                                               MgCl at                                   Reagent    No Mg++   8 mM     20 mM  30 mM                                     ______________________________________                                         Sigma (PTA)                                                                               76.0      44.9     34.8   32.4                                      Baxter (PTA)                                                                              103       47.6     34.7   30.2                                      Beckman (PTA)                                                                             43.6      43.9     40.8   38.7                                      DuPont (PTA)                                                                              103       48.9     35.9   29.6                                      Sigma (DEX)                                                                               47.0      50.0     44.9   41.4                                      Abbott (DEX)                                                                              46.1      47.5     47.5   45.5                                      DMA (DEX)  47.1      48.7     44.7   43.4                                      Mean:      66.4      47.4     40.5   37.3                                      S.D.:      27.1      2.21     5.38   6.53                                      C.V.:      40.8%     4.70%    13.3%  17.5%                                     ______________________________________                                    

                  TABLE 4B                                                         ______________________________________                                         Low Lipoprotein Level                                                          Values HDL Cholesterol mg/dl                                                   Precipitating        MgCl at  MgCl at                                                                               MgCl at                                   Reagent    No Mg++   10 mM    20 mM  30 mM                                     ______________________________________                                         Sigma (PTA)                                                                               103       77.7     22.6   24.1                                      Baxter (PTA)                                                                              114       24.5     22.8   21.9                                      Beckman (PTA)                                                                             21.0      23.5     22.4   24.3                                      DuPont (PTA)                                                                              123       23.9     23.1   22.2                                      Sigma (DEX)                                                                               22.8      22.7     25.1   24.4                                      Abbott (DEX)                                                                              22.9      23.7     25.5   25.3                                      DMA (DEX)  24.3      23.4     24.9   24.7                                      Mean:      61.5      31.3     23.8   23.8                                      S.D.:      48.7      20.5     1.35   1.29                                      C.V.:      78.9%     65.3%    5.70%  5.44%                                     ______________________________________                                    

The effect of varying the concentration of chelating agent was also examined. In particular, various concentrations of EDTA were tested and the results are set forth in Table 5. It has been found that a higher concentration of surfactant requires more divalent cation. As the level of chelating agent is increased the Mg⁺⁺ is less available and the CV rises.

                  TABLE 5                                                          ______________________________________                                         Effect of Chelating Agent Concentration                                        Values HDL Cholesterol mg/dl                                                   Precipitation      3 mM      12 mM   15 mM                                     Reagent  No EDTA   EDTA      EDTA    EDTA                                      ______________________________________                                         Sigma    39.0 mg/dl                                                                               37.0 mg/dl                                                                               33.2 mg/dl                                                                             21.6 mg/dl                                Baxter   38.0 mg/dl                                                                               37.8 mg/dl                                                                               34.5 mg/dl                                                                             23.4 mg/dl                                Beckman  39.0 mg/dl                                                                               38.8 mg/dl                                                                               36.9 mg/dl                                                                             24.9 mg/dl                                Abbott   41.0 mg/dl                                                                               40.2 mg/dl                                                                               41.3 mg/dl                                                                             40.8 mg/dl                                Mean:    39.3 mg/dl                                                                               38.5 mg/dl                                                                               36.5 mg/dl                                                                             27.7 mg/dl                                S.D.:    1.3       1.4       3.6     8.9                                       C.V.:    3.2%      3.6%      9.8%    32.0%                                     ______________________________________                                    

When the concentration of surfactant is increased from the level shown as optimum, the lipoproteins are stable but do not precipitate as they should. Therefore, the HDL values are not correct and vary depending on the precipitating agent. However, it is possible to correct for the elevated surfactant by increasing the divalent cation concentration. To illustrate, Triton X705 was increased from 0.175% to 0.350% with the elevated level of lipoprotein (80 mg/dl). Table 6 below shows the results. Instead of the optimum Mg⁺⁺ concentration being 6 mM, the optimum is increased to 25 mM when the surfactant level is increased to 0.350%.

                  TABLE 6                                                          ______________________________________                                         Requirement for Increased Divalent Cation Concentration with an                Increase in Surfactant Concentration                                           Values HDL Cholesterol mg/dl                                                   Precipitating    Concentration MgCl.sub.2                                      Reagent    No Mg++   6 mM      15 mM 25 mM                                     ______________________________________                                         Sigma (PTA)                                                                               195       115       83.4  73.6                                      Baxter (PTA)                                                                              211       125       79.9  77.5                                      Beckman (PTA)                                                                             144       122       105   86.0                                      Dupont (PTA)                                                                              211       136       82.0  76.3                                      Sigma (DEX)                                                                               79.2      81.2      81.6  80.6                                      Abbott (DEX)                                                                              79.1      80.5      79.6  81.6                                      DMA (DEX)  79.5      80.2      81.6  76.9                                      Mean:      143       106       84.8  78.9                                      S.D.:      63.3      24.4      8.93  4.1                                       C.V.:      44.4%     23.1%     10.5% 5.20%                                     ______________________________________                                    

Materials and Methods

The following materials and methods were used in carrying out the experiments described herein.

Preparation of LDL cholesterol and triglyceride control. To 0.5 liter H₂ O, add 11.91 g HEPES, 1.11 g EDTA, 0.1 g nalidixic acid, 0.3 g chloramphenicol, 0.4 g methylparaben, 5.0 g sodium chloride, 2.7 g Triton X705 and 20.0 g bovine serum albumin. Components stirred at 22° C. until dissolved. After addition of desired lipoprotein, volume is brought to 1.0 liter with H₂ O.

    ______________________________________                                                                 Intermediate                                                                              Elevated                                    Component     Low Level Level      Level                                       ______________________________________                                         .sup.1 Avian Triglyceride                                                                    11.5 ml   16.0 ml    36.0 ml                                     Concentrate 4925                                                               mg/dl                                                                          .sup.2 LDL Cholesterol                                                                        185 ml    265 ml     365 ml                                     Concentrate 950                                                                mg/dl                                                                          ______________________________________                                          .sup.1 Miles Pentex: Triglyceride Concentrate Triglycerides: 4925 mg/dl        Cholesterol: 213 mg/dl                                                         .sup.2 LDL Cholesterol Concentrate LDL Cholesterol: 960 mg/dl HDL              Cholesterol: <10 mg/dl Triglycerides: 390 mg/dl                          

Preparation of LDL cholesterol, HDL cholesterol, and triglyceride control. To 0.5 liter H₂ O, add 11.91 HEPES, 1.11 g EDTA, 0.1 g nalidixic acid, 0.3 g chloramphenicol, 0.4 g methylparaben, 5.0 g sodium chloride, 2.7 g Triton X705 and 20.0 g bovine serum albumin. Components stirred at 22° C. until dissolved. After addition of desired lipoprotein, volume is brought to 1.0 liter with H₂ O.

    ______________________________________                                                                 Intermediate                                                                              Elevated                                    Component     Low Level Level      Level                                       ______________________________________                                         MgCl.sub.2    1.90   g      0.76  g    0.57 g                                  .sup.1 Avian Triglyceride                                                                    12.2   ml     17.4  ml   38.8 ml                                 Concentrate 4925 mg/dl                                                         .sup.2 LDL Cholesterol                                                                       164    ml     225   ml   283  ml                                 Concentrate                                                                    .sup.3 HDL Cholesterol                                                                       46.0   ml     88.0  ml   146  ml                                 Concentrate 550 mg/dl                                                          ______________________________________                                          .sup.1 Miles Pentex: Triglyceride Concentrate Triglycerides: 4925 mg/dl        Cholesterol: 213 mg/dl                                                         .sup.2 LDL Cholesterol Concentrate LDL Cholesterol: 960 mg/dl HDL              Cholesterol: <10 mg/dl Triglycerides: 390 mg/dl                                .sup.3 HDL Cholesterol Concentrate HDL Cholesterol: 550 mg/dl LDL              Cholesterol: <10 mg/dl Triglycerides: 130 mg/dl                          

Lipoprotein control prepared from human serum. To 1 liter human serum, add 1.11 g EDTA, 0.1 g nalidixic acid, 0.3 g chloramphenicol, 0.4 g methylparaben, MgCl₂ and 2.7 g Triton X705 to produced a 1 liter batch. Components stirred at 22° C. until dissolved. Levels may be adjusted by adding lipoprotein concentrate.

SPECIFIC EXAMPLE 2--STABILITY

Based on the above studies, using the appropriate concentration of lipoprotein, surfactant and divalent cation, liquid lipoprotein controls were prepared and their stability examined. It was found that the control composition of the present invention is stable for up to about 12 months at about 2° C. to about 10° C. and preferably at 6° C. (refrigeration temperature). Moreover, at about 22° C. (approximately room temperature), the control composition of the present invention is stable for up to about 5 months. FIGS. 4, 5 and 6 show the HDL cholesterol, LDL cholesterol and triglyceride stability, respectively, when low, mid and elevated levels of lipoprotein are present in the control. The control composition of the present invention may thus be stored as a liquid without hindering stability.

SPECIFIC EXAMPLE 3--MATRIX EFFECTS

As noted above, lyophilized and frozen lipid controls known in the art have matrix problems. In order to demonstrate this, a study was performed to compare various commercially-available controls with fresh human serum and the control of the present invention. The results of the study are set forth in Tables 7A-7E below. The data illustrates the matrix problems associated with the use of available commercial controls, in contrast to the results with human serum and the control of the present invention. In addition, three samples of human serum were tested with several precipitating agents. As shown, all the reagents perform equally well with human serum (see Table 7A). The C. V. between methods is 3%-4%. The control of the present invention gives a C. V. between methods that is close to normal serum (see Table 7B). The C. V. between methods using Sigma, ClBA-Corning, and Bio-Rad lipid controls illustrate the large matrix values in these prior art controls (see Tables 7C-7E).

                  TABLE 7A                                                         ______________________________________                                         Human Serum                                                                    Values HDL Cholesterol mg/dl                                                   Precipitating Reagent                                                                       Sample 1    Sample 2 Sample 3                                     ______________________________________                                         Sigma (PTA)  22.2        43.7     57.8                                         Baxter (PTA) 22.0        46.1     58.5                                         Beckman (PTA)                                                                               23.0        42.2     58.1                                         DuPont (PTA) 23.1        44.9     63.0                                         Sigma (DEX)  24.6        45.1     61.9                                         Abbott (DEX) 24.3        42.2     58.3                                         DMA (DEX)    24.0        45.2     60.4                                         Mean:        23.3        44.2     59.7                                         S.D.:        1.03        1.55     2.10                                         C.V.:        4.42%       3.52%    3.51%                                        ______________________________________                                    

                  TABLE 7B                                                         ______________________________________                                         Control of Invention                                                           Values HDL Cholesterol mg/dl                                                   Precipitating                                                                  Reagent      Level 1    Level 2  Level 3                                       ______________________________________                                         Sigma (PTA)  22.6       44.9     75.6                                          Baxter (PTA) 22.8       47.6     80.6                                          Beckman (PTA)                                                                               22.4       43.9     74.5                                          DuPont (PTA) 23.1       48.9     82.9                                          Sigma (DEX)  25.1       50.0     82.0                                          Abbott (DEX) 25.5       47.5     82.0                                          DMA (DEX)    24.9       48.7     86.9                                          Mean:        23.8       47.4     80.5                                          S.D.:        1.35       2.21     4.50                                          C.V.:        5.70%      4.70%    5.59%                                         ______________________________________                                    

                  TABLE 7C                                                         ______________________________________                                         Sigma Control*                                                                 Values HDL Cholesterol mg/dl                                                   Precipitating Reagent                                                                        Level 1    Level 2  Level 3                                      ______________________________________                                         Sigma (PTA)   23.2       44.8     56.1                                         Baxter (PTA)  22.7       55.5     80.1                                         Beckman (PTA) 24.0       55.7     63.5                                         DuPont (PTA)  23.4       54.2     77.1                                         Sigma (DEX)   24.9       52.3     71.5                                         Abbott (DEX)  17.5       29.4     54.4                                         DMA (DEX)     27.4       42.8     66.7                                         Mean:         23.3       47.8     67.0                                         S.D.:         2.99       9.61     9.85                                         C.V.:         12.8%      20.1%    14.7%                                        ______________________________________                                          *Lyophilized                                                             

                  TABLE 7D                                                         ______________________________________                                         Ciba-Corning Control                                                           Values HDL Cholesterol mg/dl                                                   Precipitating Reagent                                                                        Level 1    Level 2  Level 3                                      ______________________________________                                         Sigma (PTA)   25.8       32.9     64.9                                         Baxter (PTA)  43.2       56.4     129                                          Beckman (PTA) 27.2       37.3     90.6                                         DuPont (PTA)  44.6       54.6     129                                          Sigma (DEX)   31.0       45.9     118                                          Abbott (DEX)  22.7       32.6     81.0                                         DMA (DEX)     25.3       38.3     92.4                                         Mean:         31.4       42.6     100                                          S.D.:         8.91       9.89     25.1                                         C.V.:         28.4%      23.2%    24.9%                                        ______________________________________                                    

                  TABLE 7E                                                         ______________________________________                                         Bio-Rad Control                                                                Values HDL Cholesterol Mg/dl                                                   Precipitating Reagent                                                                            Level 1  Level 2                                             ______________________________________                                         Sigma (PTA)       16.9     53.1                                                Baxter (PTA)      45.3     58.0                                                Beckman (PTA)     18.1     54.8                                                DuPont (PTA)      38.5     56.5                                                Sigma (DEX)       110      116                                                 Abbott (DEX)      21.8     52.5                                                DMA (DEX)         58.8     58.3                                                Mean:             44.1     64.1                                                S.D.:             32.8     22.9                                                C.V.:             74.3%    35.7%                                               ______________________________________                                    

SPECIFIC EXAMPLE 4--PREFERRED PROCEDURE

The following is a detailed description of the preparation of a preferred control composition of the present invention.

A tri-level lipoprotein control is prepared containing clinically significant concentration levels for cholesterol, triglycerides and HDL cholesterol. Table 8 summarizes the constituent concentration of the control.

                  TABLE 8                                                          ______________________________________                                         Measured Analytes                                                                             Level 1   Level 2  Level 3                                      ______________________________________                                         Cholesterol (mg/dl)                                                                           150-200   230-280  330-380                                      Triglycerides (mg/dl)                                                                         120-150   170-200  290-350                                      HDL Cholesterol (mg/dl)                                                                       15.0-25.0 30.0-45.0                                                                               55.0-80.0                                    ______________________________________                                    

Stock Solution:

50 mM HEPES buffer with nalidixic acid (sodium salt at 10 mg %.

250 mM EDTA disodium in HEPES buffer, (93.06 g/l).

500 mM Magnesium Chloride (MgCl₂)in HEPES buffer, (47.62 g/l).

500 mM Nalidix Acid (sodium salt) in HEPES buffer, (5.00 g/l).

250 mM chloramphenicol in HEPES buffer, (2.50 g/l)

30.0% BSA, Protease Free

5.0% Sodium Chloride in HEPES buffer, (50.00 g/l).

10% Triton X705 in HEPES buffer.

Avian Triglyceride Concentrate (Miles).

Human LDL & HDL Cholesterol (Continental Services).

30% Triton X705 in HEPES buffer, (≈462.9 g/l).

It should be noted that the control is sensitive to microbial contamination and prolonged exposure to excessive heat (>30° C.). Any microbial contamination or prolonged exposure to high temperatures will compromise the stability of some components.

One liter of each level of control may be made using the stock solutions at the concentrations set forth in Table 9, combined in the order set forth in Table 9.

                  TABLE 9                                                          ______________________________________                                         Preferred Lipoprotein Control                                                  Volumes of Stock Solution to Make 1 Liter of Control                           Stock Solution                                                                             Level 1    Level 2    Level 3                                      Lipid Control                                                                              1 Liter    1 Liter    1 Liter                                      ______________________________________                                         MgCl.sub.2 *                                                                               40.0    ml     16.0  ml   12.0  ml                                 EDTA Disodium*                                                                             12.0    ml     12.0  ml   12.0  ml                                 HEPES Buffer                                                                               488     ml     429   ml   325   ml                                 Nalidixic Acid                                                                             5.55    ml     7.65  ml   10.3  ml                                 Chloramphenicol                                                                            86.6    ml     74.2  ml   58.1  ml                                 Triton X705 13.8    ml     12.0  ml   10.0  ml                                 Sodium Chloride                                                                            75.4    ml     67.0  ml   57.0  ml                                 Avian       2.00    ml     2.50  ml   20.0  ml                                 Triglycerides                                                                  Albumin     66.7    ml     66.7  ml   66.7  ml                                 Methylparaben                                                                              0.288   g      0.246 g    0.185 g                                  LDL Cholesterol                                                                            164     ml     225   ml   283   ml                                 ≈950.0 mg/dl                                                           HDL Cholesterol                                                                            46.0    ml     88.0  ml   146   ml                                 ≈550.0 mg/dl                                                           ______________________________________                                          *Th MgCl.sub.2 and EDTA Disodium are allowed to chelate for 10 minutes.  

SPECIFIC EXAMPLE 5--MULTI-ANALYTE CONTROL

As described above, additional constituents such as analytes may be combined with the control composition of the present invention. Thus, a "multianalyte" or "complete chemistry" control is also within the scope of the present invention. The following is a list of tests which may be performed with a control composition of the present invention containing the appropriate constituents: potassium, BUN, glucose, uric acid, bilirubin, creatinine, sodium, alanine aminotransferase, y-glutamyltransferase.

Table 10 indicates the various constituents and concentrations employed in a two level control to be used on chemistry analyzers (e.g. analogous to the Boehringer Refiotron, Abbott Vision and Kodak Ektachem).

                  TABLE 10                                                         ______________________________________                                         Measured Analyte (Units)                                                                          Level 1  Level 2                                            ______________________________________                                         Cholesterol (mg/dl)                                                                               170-190  250-270                                            HDL Cholesterol (mg/dl)                                                                           45.0-52.0                                                                               20.0-27.0                                          Triglycerides (mg/dl)                                                                             170-200  280-320                                            Bilirubin (mg/dl)  1.10-1.40                                                                               4.60-5.20                                          Creatinine (mg/dl) 1.30-1.60                                                                               4.90-5.50                                          Glucose (mg/dl)    90.0-105 40.0-50.0                                          Potassium (mmol/l) 3.0-4.0  7.0-9.0                                            Urea (mg/dl)       27.0-33.0                                                                               47.0-55.0                                          Uric Acid (mg/dl)  6.00-7.00                                                                               8.00-9.00                                          ______________________________________                                    

Stock Solution:

50 mM HEPES buffer with Nalidix Acid (sodium salt) at 10 mg %.

225 mM EDTA Disodium in HEPES buffer, (83.75 g/l).

500 mM Magnesium Chloride (MgCl₂) in HEPES buffer, (47.60 g/l).

0.50% Nalidixic Acid (sodium salt) in _(d) H₂ O, (5.00 g/l).

250 mg % Chloramphenicol in HEPES buffer, (2.50 g/l).

1M Potassium Chloride (KCL) in HEPES buffer, (74.55 g/l).

3% Urea (BUN) in HEPES buffer, (30.00 g/l).

0.5% ANS (Bilirubin) in HEPES buffer, (5.00 g/l).

20% Glucose in HEPES buffer, (200.00 g/l).

1.0% Uric Acid in HEPES buffer, (1.00 g/l).

30.0% BSA, Protease Free, (Hematology Grade).

5.0% Sodium Chloride in HEPES buffer, (50.00 g/l).

10% Triton X705 in HEPES buffer.

Avian Triglyceride Concentrate (Miles)

Human LDL and HDL Cholesterol. (Continental Services)

30% Triton X705 in HEPES buffer, (≈462.9 g/l).

One liter of each level of control may be made using the stock solutions as the concentrations set forth in Table 11, combined in the order set forth in Table 11.

                  TABLE 11                                                         ______________________________________                                         Multi-Analyte Control With Lipoproteins                                        Volumes of Stock Solution to Add to Make 1 Liter of Control                    Stock Solution  Level 1   Level 2                                              Multi-Analyte   1 Liter   1 Liter                                              ______________________________________                                         MgCl.sub.2 *    30.0   ml     30.0   ml                                        EDTA Disodium*  12.0   ml     12.0   ml                                        HEPES Buffer    398    ml     277    ml                                        Nalidixic Acid  5.90   ml     7.45   ml                                        Chloramphenicol 84.5   ml     75.3   ml                                        KCL (Potassium) 4.50   ml     7.00   ml                                        Urea (BUN)      22.0   ml     40.0   ml                                        ANS (Biulirubin)                                                                               1.40   ml     7.50   ml                                        Glucose         5.00   ml     2.50   ml                                        Creatinine      1.20   ml     5.60   ml                                        Uric Acid       70.0   ml     100    ml                                        Triton X705     13.6   ml     12.4   ml                                        Sodium Chloride 57.0   ml     51.0   ml                                        Avian Triglycerides                                                                            2.50   ml     15.0   ml                                        Albumin         66.7   ml     66.7   ml                                        Methylparaben   0.280  g      0.250  g                                         LDL Cholesterol 138    ml     248    ml                                        HDL Cholesterol 88.0   ml     43.0   ml                                        ______________________________________                                          *The MgCl.sub.2 and EDTA Disodium are allowed to chelate for 10 minutes. 

Again it should be noted that the control is sensitive to microbial contamination and excessive heat. Any microbial contamination or prolonged exposure to high temperatures will compromise the stability of some components.

The foregoing discussion discloses and describes merely exemplary embodiments of the present invention. One skilled in the art will readily recognize from such discussion, and from the accompanying drawings and claims, that various changes, modifications and variations can be made therein without departing from the spirit and scope of the invention as defined in the following claims.

All patents and references cited herein are incorporated by reference. 

We claim:
 1. A liquid lipoprotein control composition comprising:a) a lipoprotein; b) a surfactant present in an amount directly proportional to the amount of lipoprotein; and c) a divalent cation present in an amount inversely proportional to the amount of lipoprotein.
 2. The composition of claim 1, wherein the lipoprotein is selected from the group consisting of HDL cholesterol, LDL cholesterol and triglyceride.
 3. The composition of claim 1, wherein the divalent cation is selected from the group consisting of Mg⁺⁺, Ca⁺⁺ and Mn⁺⁺.
 4. The composition of claim 1, wherein the lipoprotein comprises from about 0.1% to about 1.5% by weight of the composition, the surfactant comprises from about 0.01% to about 0.5% by weight of the composition, and the divalent cation comprises from about 0.05% to about 1.0% by weight of the composition.
 5. The composition of claim 1, further comprising a chelating agent.
 6. The composition of claim 1, further comprising a compound selected from the group consisting of glucose, bilirubin, potassium, urea, creatinine, sodium, uric acid, alanine aminotransferase and y-glutamyltransferase.
 7. The composition of claim 5, wherein the chelating agent is selected from the group consisting of EDTA, EGTA and sodium citrate.
 8. A method of determining the accuracy of a lipoprotein determination method comprising the steps of:a) providing a liquid lipoprotein control composition having a known lipoprotein concentration, wherein the composition comprises a lipoprotein, a surfactant present in an amount directly proportional to the amount of lipoprotein and a divalent cation present in an amount inversely proportional to the amount of lipoprotein; b) determining the lipoprotein concentration of the control composition; and c) comparing the concentration of lipoprotein obtained in step b) with the known lipoprotein concentration.
 9. The method of claim 8, wherein the lipoprotein is selected from the group consisting of HDL cholesterol, LDL cholesterol and triglyceride.
 10. The method of claim 8, wherein the divalent cation is selected from the group consisting of Mg⁺⁺, Ca⁺⁺ and Mn⁺⁺.
 11. The method of claim 8, wherein the lipoprotein comprises from about 0.1% to about 1.5% by weight of the composition, the surfactant comprises from about 0.01% to about 0.5% by weight of the composition, and the divalent cation comprises from about 0.05% to about 1.0% by weight of the composition.
 12. A liquid lipoprotein control composition comprising:a) HDL cholesterol; b) LDL cholesterol; c) a surfactant present in an amount directly proportional to the amount of HDL cholesterol and the amount of LDL cholesterol; d) a divalent cation present in an amount inversely proportional to the amount of HDL cholesterol and the amount of LDL cholesterol; and e) up to about 12 mmol chelating agent,wherein the control is stable for up to about six months at about 2° C. to about 10° C.
 13. The control of claim 12, wherein the divalent cation is selected from the group consisting of Mg⁺⁺, Ca⁺⁺ and Mn⁺⁺.
 14. The control of claim 12, wherein the chelating agent is selected from the group consisting of EDTA, EGTA and sodium citrate.
 15. The control of claim 12, further comprising a compound selected from the group consisting of glucose, bilirubin, potassium, urea, creatinine, sodium, uric acid, alanine aminotransferase and y-glutamyltransferase. 